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This is just one piece of a generational standard. This places the client’s privacy The new standard-bearers
societal shift toward open sharing and community. That shift is reflected in the growth of ride-sharing apps like Lyft and Uber, the decline in people planning to ever own a home (Pew Research Center, 2010), and the continued growth of social media. It also raises important questions for family therapists, particularly related to our ethical standards. If the Code of Ethics (AAMFT, 2015) is supposed to reflect commonly held standards and expectations of MFTs, what happens when a new generation of therapists comes in with very different standards and expectations?
We impose privacy, even when it is not wanted
Confidentiality, at least, can be waived. Clients can sign releases acknowledging the risks of doing therapy in more open settings and allowing information from their treatment to be shared. Some of the other ethical standards for MFTs don’t offer the same flexibility. For example, MFTs engaging in video-based practices may find that their clients would happily choose the convenience of software they already have (commonly, Skype) over the security of software they have to find and download. But clients cannot waive our ethical requirement to provide secure platforms of communication (standard 6.1[c] in the current code), even if they prefer it.
It is problematic if client and therapist agree that an ethical standard is outdated. In a best-case scenario, the therapist would follow the standard, while also making the disagreement with it known to AAMFT. The client might be irritated that the therapist is following the standard, but would download the more secure software, and potentially be better protected by having done so.
In a worst-case scenario, the client and therapist agree to simply disregard the
at risk, but he or she has already indicated that is not a concern. So the greater danger may be for the profession as a whole. If one ethical standard is routinely disregarded, it becomes more difficult
to argue that the rest of them deserve strong respect and adherence.
It was never really there
One reason why millennial therapists and clients may deprioritize privacy is that they do not believe true privacy exists. Large-scale corporate and healthcare data breaches are unfortunately common. The PATRIOT Act greatly expanded the U.S. government’s ability to gather information on its own citizens. And as many stories have illustrated, very little of what you post online is ever truly private.
From a more positive perspective, many therapists and clients have experienced great benefit when they have chosen to reduce their personal privacy, particularly on social media. Students, interns, and clients have all shared experiences with me where they took risks and shared personal information and struggles online that they otherwise would have kept private. Usually, the world around them responded with compassion.
These individual experiences, alongside the larger social and political changes, suggest that the way we look at privacy is changing. Millennials in particular have nuanced ideas and practices around privacy. They are generally
open in sharing personal experiences. They are not especially concerned about government surveillance, and do not believe most companies protect their privacy. Four in five say they are not worried at all, or are only a little worried, about the information available about them online (American Press Institute, 2015). In other words, they don’t want their identity to be stolen. But they are fine with it being known.
For clarity’s sake, I am not arguing that current ethical standards surrounding privacy and confidentiality in therapy should be changed any time soon. They exist for good reason, and the safeguards we are required to have in place for client privacy and security have great value.
I believe it is both ethically and morally correct to protect clients from dangers that they do not see or understand, even when doing so risks appearing paternalistic.
I also know that as I gather age and experience, the basis for my viewpoint gradually becomes less aligned with the experiences of younger therapists. The day is coming when newer therapists give strong voice to the argument that openness, transparency, and client choice should be prioritized over a singular mandate of privacy. Especially when
that singular mandate is no longer one in which clients or their therapists believe.
Benjamin E. Caldwell, PsyD, is a Clinical Fellow
of AAMFT in
Los Angeles and
a member of the AAMFT Ethics Committee. He
maintains a blog on professional issues in mental health.
GO ONLINE >> www.PsychotherapyNotes.com
References
AAMFT. (2015). Code of ethics. Retrieved from www.aamft.org/ code-of-ethics. Alexandria, VA.
American Press Institute (2015). Digital lives of Millennials. Retrieved from https://www.americanpressinstitute.org/ publications/reports/survey-research/digital-lives-of- millennials.
Pew Research Center (2010). Millennials: Confident. Connected. Open to change. Retrieved from http://www.pewsocialtrends. org /files/2010/10/millennials-confident-connected-open-to- change.pdf.
SAMHSA (2015). Recovery and recovery support. Retrieved from https://www.samhsa.gov/recovery.
This article is authored by an AAMFT member and does not reflect the opinion of AAMFT or the AAMFT Ethics Committee and is intended for informational use only. If you would like to contribute an article focused on ethics issues, please send an email to ethics@aamft.org. For more information on the Code of Ethics, see www.aamft.org/code-of-ethics.
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